Experts are warning of a mental health emergency as the number of children waiting over a year for mental health treatment has nearly tripled from pre-pandemic levels to more than 1,500.

The Royal College of Psychiatrists has said it does not know how the government expects to meet rising demand without a significant increase in funding.

In one health board the average waiting time for children and young people who started treatment in the fourth quarter of 2020 was 43 weeks – six times the national average.

Currently just 0.5% of the NHS Scotland budget is spent on child and adolescent mental health services (CAMHS), leading to claims they have been overlooked even before the pandemic.

Dr Helen Smith, Chair of the Children and Adolescent Faculty at the Royal College of Psychiatrists in Scotland, said: “We do not know how the Scottish government expects us to keep meeting the increased demand for support without increasing the capacity of services.

“That is why we’re now calling on the government to commit 1% of its health budget to CAMHS services by 2026.

“What we have is a potential mental health emergency on our hands, which will burden future generations. We need CAMHS to be seriously acknowledged. Funding must be looked at for the sake of our children and young people.”

More than 11,000 patients were waiting for CAMHS treatment by December, roughly in line with numbers from December the previous year.

However, the make-up of the waiting list has shifted during the pandemic, with longer waits becoming more common: 14% had been on the list for more than a year compared to just 5% in December 2019.

The percentage waiting between 36 and 52 weeks doubled from 9% to 18% over the year.

The Scottish government target is for 90% of patients to be seen within 18 weeks of referral.

Public Health Scotland’s report suggests disruption to education could be to blame.

‘This is potentially due to a combination of school closures, some children and young people not having access to a safe/confidential space to engage in digital appointments, or have a desire to wait for an in-person appointment,’ the report states.

Dr Helen Smith added: “It’s disappointing that more young people are having to wait a year or more for a mental health appointment, but the truth is these services were already under-resourced, understaffed and short-changed before the covid-19 crisis hit.

“We recently ran a members poll with 76 CAMHS psychiatrists, which revealed 84% think services are very insufficiently or insufficiently resourced, while 43% said they are poorly staffed.

“The increase in waiting times is also a reflection on the reduction in available staff across the country and the fact we’re not training enough CAMHS psychiatrists.”

Also raising concern is the Scottish Children’s Services Coalition, which represents charities and organisations working with vulnerable young people and their families.

“These latest figures are deeply troubling,” the Coalition says, “and point to a highly challenging environment for both our young people and our mental health services.

“We welcome the fact that the Scottish government is intending to invest more than £1.1bn in mental health services overall, but significantly greater funding is needed to address the current crisis facing our children and young people.

“…The fact that more than 1,500 of our most vulnerable children have been waiting more than a year for treatment in this respect is deeply disturbing.

“We would urge the Scottish government to look to not just the NHS, but the third sector and other private sector organisations to play a key role in this, renewing its focus on prevention and early intervention. Our mental health services must receive the funding they vitally need, or we face having a ‘lost generation’ of vulnerable children and young people.” 

In Forth Valley, where just 37% of patients were seen within the government target of 18 weeks, the health board said:

“We are continuing to prioritise urgent referrals and those who have experienced longer waits which adversely impacts on our performance against the 18-week standard.

“A further reason that our waiting times appear to be an outlier is because, unlike other areas, our local CAMHS service accepts referrals for the assessment and diagnosis of neurodevelopmental disorders, like Autistic Spectrum Disorder and Attention Deficit Hyperactivity Disorder. These account for a significant number of referrals which has an impact on our reported performance against the 18-week referral to treatment standard. 

“Our staff are working closely with the Scottish Government to review our reporting mechanisms to try to address this inconsistency. National recommendations have also been put forward to support the development of specific services for children and young people who require support for neurodevelopment difficulties.

“In addition, CAMHS staff are working closely with local council partners to support the introduction of new mental health and counselling services in schools…We are also working with the independent sector to increase access to a range of therapies.”

Mental Health Minister Clare Haughey said: “It is encouraging that we have seen a significant increase in performance this quarter, which demonstrates the priority we have placed on CAMHS as we move through phases of recovery from the pandemic.

“CAMHS staffing has also increased, and we will continue to expand the workforce.

“However, we want to go further as long waits are unacceptable. Our Transition and Recovery Plan sets out a number of actions to progress improvement on access to CAMHS and Psychological Therapies, backed by significant investment.

“The £120m we have announced for our Mental Health Recovery and Renewal Fund is the single largest investment in mental health in the history of devolution. It will prioritise our ongoing work to improve specialist CAMHS services, address long waiting times, and clear waiting list backlogs.

“The direct investment from the Scottish government of over £262m for mental health in the coming financial year means that we have more than doubled our mental health budget for 2021/22 when compared with 2020. That takes total Scottish spending on mental health in 2021/22 to in excess of £1.2bn.

“We recognise that not all children and young people need specialist services like CAMHS, which is why we announced funding of £15m to be distributed to local authorities to support the mental wellbeing 5 to 24 year olds in their communities. 

“We will also continue to prioritise support for children and young people’s mental health and wellbeing in education, through our £60m investment to ensure secondary schools have access to a counselling service.”

 

Read more: Mental health cash boost cannot be ‘one off’; ‘Gaping holes’ in psychiatrist numbers; Psychiatry fair funding plea as admissions soar; Support boost amid children’s mental health concerns

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